Provider Demographics
NPI:1760107163
Name:SCHENCK, AMY E (LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:SCHENCK
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12326 COUNTY ROAD 1139
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75709-6340
Mailing Address - Country:US
Mailing Address - Phone:903-570-7889
Mailing Address - Fax:
Practice Address - Street 1:12326 COUNTY ROAD 1139
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75709-6340
Practice Address - Country:US
Practice Address - Phone:903-570-7889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-07
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85269101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health